Patient perceptions and preferences of physicians' attire in Saudi primary healthcare setting

Background: Since the time of Hippocrates, dress of the care-giver has been known to influence patient's perception about the physician. Objectives: To explore patient's preference about physician's dress in Saudi primary healthcare, and how it influences their perception, regarding professionalism, competence, and confidence in the physician. Methods: A cross sectional study conducted in primary care clinics in Riyadh, enrolling 443 patients, who filled a self-administered Arabic questionnaire, enquiring about physician clothes such as white coat, scrubs and 'thob (white-robe) shomagh (head cover)' for males, 'veil-skirt' for females, and shoes. Patients' preferences about physicians' dresses were explored and influence of favorable dress on professionalism and trustworthiness were explored, using Chi-sq, Mann Whitney, with p <= .05 as significant. Principle component analysis was used to search themes in attire commonly used. Results: Over 80% of patients visiting Saudi primary care, liked seeing their physician in white coat. Traditional dress 'thob and shomagh' was approved by 47% whereas 'veil and skirt' got acceptance of 62%. Dress of physician was significantly (p < .005) more important to patients, who were male (Chi-sq 14.95), working (Chi-sq 9.39), educated (Chi-sq 9.84), urbanites (Chi-sq 18.34) and married (Chi-sq 7.89). Patients who valued physician attire (70%) perceived it positively influencing doctor-patient relationship: Mann Whitney U score = 6879, p-value <0.001. Four dress-themes emerged: 'Professional modest', 'Expensive modern', 'Traditional formal' and 'Casual shoes'. Conclusion: Patients preferred white coats for their doctors. Half of participants accepted traditional dresses. Majority valued physician's attire as a positive influence.